How much rates vary
Facilitymedian $776 · 10th to 90th $282 to $5,012Professionalmedian $309 · 10th to 90th $26 to $550
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $575.44 | Professional | None | $338.84 | $446.68 | $575.44 |
BCBS Texas Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $977.24 | Facility | None | $239.88 | $309.03 | $977.24 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $549.54 | Professional | None | $309.03 | $407.38 | $549.54 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $2,290.87 | Facility | None | $302.00 | $426.58 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $549.54 | Professional | None | $316.23 | $407.38 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,801.89 | Professional | None | $3,162.28 | $3,162.28 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $1,000.00 Typical High $4,677.35 | Facility | None | $363.08 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $549.54 | Professional | None | $338.84 | $446.68 | $549.54 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $77.62 Typical High $380.19 | Professional | None | $16.22 | $77.62 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $436.52 Typical High $2,290.87 | Facility | None | $309.03 | $436.52 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $549.54 | Professional | None | $316.23 | $407.38 | $549.54 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $524.81 | Professional | None | $269.15 | $363.08 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | None | $426.58 | $446.68 | $446.68 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $169.82 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $67.61 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $407.38 | Professional | 54 · Surgery only | $257.04 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.88 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $309.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $239.88 | $309.03 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $169.82 | $223.87 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $67.61 | $89.13 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $407.38 | Professional | 54 · Surgery only | $257.04 | $331.13 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.88 | $44.67 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $309.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $239.88 | $309.03 | $380.19 |
Where Texas sits
The same service costs 5.0 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 50th of 51
$316
AK $1,380UT $275
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.